While doulas have been growing in popularity for their work related to childbirth and the early postpartum period, their value in all areas of reproductive health is just beginning to percolate in the public eye.
Traditionally, the people who attended the births in their communities provided support during ALL areas of reproductive health. Preconception, fertility, preventing pregnancy, miscarriage and loss, abortion, childbirth, the early postpartum period, and even end-of-life care were all in the realm of the same community practitioners. If you’re interested in the history of this, check out this previous post on The History of Abortion and Midwifery.
The need for support in these areas that has always existed, though who the people are in the community who fulfill this need has changed over time with various titles, specific roles and in various political climates. Many modern day full-spectrum-doulas now meet this important need in our culture as community-based professionals who offer non-medical support to the families they serve during the various parts of their reproductive lives.
If you aren’t familiar at all with the doula profession, there are plenty of articles on my blog describing what a birth doula is and the difference between a midwife and a doula. For the purposes of this post, though, I want to focus on some of the lesser known aspects of reproductive health support doulas can provide.
Doulas For Miscarriage
Surprisingly, many people don’t realize they can call on their doula to support them during a time of miscarriage or unexpected pregnancy loss. When I was a new doula, I would often get an email or text message from a birth doula client well after the fact, letting me know that they would not be needing the services they’d booked with me as the pregnancy had unexpectedly ended. Often years later, those same clients, now booking me for my doula services with a subsequent pregnancy, would express to me that they felt alone during their experience of loss and wish they’d had more support from someone.
It wasn’t until several years into my doula career that I realized not only that the skills I had as a birth doula were extremely applicable to supporting people through miscarriage, but that it was up to us as doulas to work on how we made ourselves available to clients during these experiences so that they new they absolutely COULD have the gentle and knowledgeable emotional and physical support they wished they had had during their miscarriage or loss.
Just like in birth, the physical sensations and emotional process of a miscarriage or pregnancy loss can be powerful. From the body’s perspective, a mini-birth is happening. The uterus is contracting in order to release the pregnancy, hormonal changes are occurring to allow this to happen, and there is need for a physical (and sometimes emotional) recovery process afterwards. Having an experienced doula to come and be with you in this time to keep you nourished, comforted and reassured can be such a gift, just like it can be in birth.
In addition to the physical and emotional comfort provided, there is often a lot a doula can do for you if you are being presented with options for managing your miscarriage by a health care provider. Again, just like in birth, a doula can help walk you through how to make an informed choice about the options being presented to you, and often help you find alternatives that may not have initially been offered. Like a full-term client being offered an induction, people who are experiencing a miscarriage and waiting for the pregnancy to release are often offered medical options to speed up the process. Miscarriages do not always need to be equated with medically managed approaches, and a doula can help you find the information you need to decide which routes feel best to you.
Your doula will remind you that the ultimate decision is always up to you and help make sure you feel powerful in your choices as you decide what is best for your body, your health and your experience.
Doulas For Planned Abortion
The doula support that is beneficial for abortion is so overlapped with that for miscarriage that I hesitated in separating the two into two separate categories! The physical experiences, options for approaches and types of comfort provided are essentially the same for a miscarriage and a planned abortion, the only difference being that miscarriages and losses are unplanned, while abortions are planned. Our culture sometimes forgets to create the space for abortions being empowering, positive experiences, and doulas can help make sure you feel confident, supported, and fully informed as you weigh your options, as well as provide you with in-person comfort depending on the type of approach you choose.
The emotional experiences of the two can be so, so similar, as well. Every person is different, and while one person having a miscarriage may be completely at peace with it while another is devastated, likewise, one person choosing to end a pregnancy may be feeling a profound loss while another is emotionally content. The doula’s job is not to make assumptions about what you are feeling in either experience, but to be available to you as you go through whatever emotions may be coming up for you, and help direct you to resources and professionals in your community for additional emotional support if needed.
Doulas For Fertility And Reproductive Health
Fertility doesn’t just mean a focus on trying to conceive! It can also mean managing your fertility to prevent pregnancy in a variety of ways.
Fertility management and reproduction are all in the same realm here as far as doula support goes. While the physical comfort is not needed here the way it can be in miscarriage or abortion, the emotional support and informed choice advocate piece is very much present. Doulas can help guide you through making your choices and offering alternative approaches to consider whether you are preparing to conceive or planning to avoid pregnancy.
Like in birth, doulas are amazing for reminding you that you have the ability to work with your own body and helping you understand how your body works! They can assist you in understanding self-directed ways to manage your fertility (Fertility Awareness Education) and guide you to further resources and practitioners depending on your needs and plans.
“Fertility” doesn’t just mean fertility “problems”! It can mean learning to understand your own healthy physiology and using that knowledge to either achieve or avoid pregnancy. It also may mean you are pursuing a pregnancy but have a same-sex partner or no partner and are exploring options for growing a family in this context.
If you are preparing for a pregnancy or birth while working with a fertility clinic, using donor sperm, a surrogate, or any other means of having a child and want continuity of support and advocacy from the preconception period through to birth and postpartum, a doula can often be an invaluable guide and support through this process from beginning to end.
The skills a doula has in providing emotional and physical support, facilitating informed choice conversations, and often offering an alternative perspective to common medically-managed options are exactly the same whether they are being used for a birth, a miscarriage or loss, planned abortion or in fertility.
Like birth, all of these experiences can greatly benefit from the gentle and informed approach a doula takes with her clients. These areas of doula support are still growing, and different doulas will have different levels of experience, education and interest in working in these varied areas of reproductive health.
If you are looking for non-medical support through miscarriage, abortion, or fertility experiences, find out who the doulas are in your area who work in these areas! Our long history of community-based, non-medical support in these areas is still alive and well, and it can bring so much to the table in terms of how people experience and remember these important times in their lives.
Are You A Doula Who Wants To Broaden Your Spectrum?
If you are a doula, and would like to learn more about these topics yourself, check out my More Wise Continuing Education Program for doulas. We have a segment on Broadening The Spectrum: Miscarriage and Fertility Literacy for Doulas that can help you expand the services you offer to your clients:
Continuing Education for Doulas
December 2, 2018, 9:00am – 2:30pm in Vancouver, BC
- Miscarriage Support For Doulas (*abortion positive class) (9:00am – 11:30am) $45 : SIGN UP
- Fertility Literacy For Doulas(12:00pm – 2:30pm) $45: SIGN UP
Feel free to contact me for full-spectrum doula support or referrals if you are looking for support or education in Vancouver, BC.